Individual
PRACELLAR FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 CENTRAL AVE, WESTFIELD, NJ 07090-2560
(732) 204-1635
Mailing address
225 PARK HILL AVE APT 5J, STATEN ISLAND, NY 10304-4756
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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